Evaluating the Uptake of Antiracism Training, Policies, and Practices in Departments of Family Medicine

Abstract

Background: Recent attention and focus on, antiracism training in health care has potential to accelerate our path to social justice and achieve health equity on a national scale. However, theoretical frameworks and empirical data have yet to emerge that explain the uptake of antiracism trainings and their efficacy.Objective: This goal of this study was to test hypotheses regarding uptake of antiracism training in Family Medicine departments using Diffusion of Innovation Theory.Methods: In 2021, we incorporated 10 survey items in the Council of Academic Family Medicine Educational Research Alliance's national omnibus survey for Department of Family Medicine Chairs (n = 104). We used DOI (Diffusion of Innovation) attributes (ie, relative advantage, compatibility, complexity, trialability, and observability) as a guiding framework to assess perceived innovation of antiracism training. We also evaluated the mode of training (eg, didactic, experiential) and whether any subsequent policy or practice-level antiracist actions occurred. We used c 2 tests to examine associations between DOI attributes and antiracist actions; and logistic regression to determine odds of association.Results: Ninety-two percent of respondents indicated antiracism training was happening in their department. Relative advantage, compatibility and observability were positively associated with antiracist actions, P < .05. Perceived relative advantage was associated with implementation of antiracist action (OR 1.94,. Complexity and trialability were not statistically significantly associated with action.Conclusion: Our findings provide evidence of DOIs influence on antiracism uptake in Departments of Family Medicine. We believe our findings can facilitate the future implementation of antiracism training activities and actionable antiracist policies and practices.

Family Medicine Researchers Explore the Social Determinants of Health, COVID-19 Issues, and Cancer Survivor Care

“…A Council of Academic Family Medicine Educational Research Alliance (CERA) study explores antiracism training within academic Departments of Family Medicine as reported by Department Chairs. 10 As we continue to work toward equity in family medicine, studies like this one highlight how much work we have ahead of us. Another CERA study report explores the expansion of point-of-care ultrasound (POCUS) training among faculty in departments of family medicine.…”

Response: Re: Evaluating the Uptake of Antiracism Training, Policies, and Practices in Departments of Family Medicine

“…To the Editor: In their letter to the editor, Hogans-Mathews et al 1 provide important considerations that expand the scope of the conversation related to our article "Evaluating the Uptake of Antiracism Training, Policies, and Practices in Departments of Family Medicine." 2 In their response, Hogans-Mathews et al highlight advancing the aims of systems of care to include equity as a core outcome. They describe ways to build toward a sustainable foundation of balanced representation among those underrepresented in medicine (URiM) with partnered allyship from non-URiM colleagues.…”

Re: Evaluating the Uptake of Antiracism Training, Policies, and Practices in Departments of Family Medicine

“…To the Editor: We were pleased to read the article entitled, "Evaluating the Uptake of Antiracism Training, Policies, and Practices in Departments of Family Medicine" by Sanders et al, which focuses on the use of Diffusion of Innovation Theory to evaluate antiracism trainings in departments of Family Medicine (FM). 1 We applaud this much needed evaluation of FM departments and their current practices with antiracism trainings, policies, and implementation uptake and efficacy. We also agreed with the need to promote equity in health and social justice with multiple interventions including antiracism training.…”

“…We also agreed with the need to promote equity in health and social justice with multiple interventions including antiracism training. 1 The promotion of equity and diversity are of utmost importance in medicine. A more recent proposal to the Quadruple Aim, coined the Quintuple Aim, adds a fifth aim: advancing health equity.…”

“…2 It is imperative that "antiracist long haulers'' are present so that we move beyond "performative allyship" to true action in creating environments of safety, equity, acceptance and diversity for URiMs and others. 1 The need for non-URiM allies in medicine to join the plight for antiracism and equity cannot be overstated. A review of the demographic makeup of FM department chairs was very revealing.…”